NPI 1831395540

Beverly Jean Malm, IDC

Practitioner Independent Duty Corpsman Diamondhead, MS

Practice location

Address: 8816 Manoo St, Diamondhead, MS 39525-4221
Phone: (228) 223-3763

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1831395540
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Jun 2007
Record last updated: 15 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.